Using plants to fight AIDS

Scientists study Sutherlandia grown and gathered by traditional healers in South Africa

Sutherlandia frutescens has many traditional usesTICIPS

While use of anti-retroviral (ARV) drugs among South Africa's AIDS sufferers has become more widespread in recent years, many continue to find themselves ineligible under WHO criteria to receive ARVs. For these patients, medicinal plants, such as Sutherlandia frutescens, may be their best option.

Used by the Khoi San and Nama people (the original inhabitants of the Western Cape) for the washing of wounds and to bring down fevers, Sutherlandia (also known as Lessertia frutescens), continues to be used for these purposes today, as well as for treating eye troubles, colds, flu and many other ailments. But the plant, which occurs naturally throughout the dry parts of southern Africa, has also been shown to dramatically improve the appetite of patients with diseases such as cancer, TB and AIDS, as well as improving their energy levels and providing a sense of well-being.

Assessing Sutherlandia for HIV/AIDS

Validating both the effects of medicinal plants such as Sutherlandia, and their possible interactions with modern medicines, is the raison d'être of the International Centre for Indigenous Phytotherapy Studies* (TICIPS). The Centre, developed through collaboration between the University of Missouri-Columbia and the University of Western Cape, is currently planning research to determine plant effectiveness with regards to HIV/AIDS and secondary infections.

The research will include clinical trials of Sutherlandia, which are due to start as soon as regulatory approval is granted.The trial will involve volunteer subjects - approximately 130 HIV-positive adults who are not yet eligible for anti-retrovirals - who will be randomly grouped and given the Sutherlandia product in capsule form, or a placebo of similar appearance. The main aims of the trial will be to assess the safety of Sutherlandia in HIV-infected adults, and to determine its efficacy in affecting quality of life and depression.

Protecting indigenous knowledge

Sutherlandia frutescens flower and podsSANBI

Six traditional healers are acting as full collaborators in the research, helping to design the study and recruit and evaluate the volunteers. South Africa is home to some 200,000 traditional healers and 22,000 allopathic doctors. They are extremely popular among the widely varied peoples and cultures of the 'rainbow nation', providing patient-focussed health care in a holistic and culturally appropriate manner. Trust and respect for traditional healers is also high, underlining the importance of collaboration between traditional and mainstream health care providers.

The TICIPS scientists are also taking care to protect healers' traditional knowledge. According to Dr William Folk, co-director of the Centre, TICIPS adheres to the Convention for Biological Diversity signed at the 1992 Earth Summit, which addresses the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits from the use of genetic resources. Folk's team has also created an Access and Beneficiation Agreement that conforms to the laws of the South African Government. This document ensures communities will benefit economically if, in future, profits are made from plants that healers have identified as medicinal.

Community-based projects

Dr. Nigel Gericke, who has studied Sutherlandia extensively, says he hopes the upcoming trials will scientifically and clinically validate the effectiveness of Sutherlandia in its role as an immune modulator in those HIV positive patients not yet requiring ARV's.

Sutherlandia bush with dry podsSANBI

While the South African government has never formally or informally promoted Sutherlandia - perhaps due to controversy over alleged past support for other natural products - the plant, Gericke says is being grown in South Africa and Zimbabwe in community-based projects. "It is also being grown commercially by a number of farmers," he says. Although an estimate of total production does not currently exists, he believes at least 100,000 people in the region are taking Sutherlandia products (teas and tablets) each month. Although he emphasises that, "It is not possible to know how many are using it for HIV as many people simply take Sutherlandia as a wellness supplement."

While Gericke says there is no defined market for Sutherlandia, this may change with clinical proof of efficacy. He names an additional challenge to the producer; deciding what plant material to grow. "Sutherlandia is quite complex and variable," he notes, "and there are as yet no international standards." He advises potential producers of new natural products to learn to grow plants on a small scale, and keep an eye on developments in the science, standards and most importantly, the market.

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*TICIPS is a cooperative agreement between the US National Institute of Health, the University of Missouri-Columbia and the University of the Western Cape in South Africa, with affiliations to other American and South African institutions.